Fee Assistance Application Form (K-W Water Polo)

Print Fee Assistance Application Form

KW Water Polo Club
FEE ASSISTANCE APPLICATION

Athlete's Basic Information

Athlete's First Name^*
Athlete's Last Name^*
Athlete's Gender Identity^*

Athlete's Date of Birth^*

Open the calendar popup.

Primary Email Contact^*

Email address monitored most frequently for this Athlete - Example: [email protected]. A copy of your membership application will be sent to this address.

Athlete's Contact Information

Athlete's Street Address^*
Athlete's City^*
Athlete's Postal Code^*
Athlete's Home Phone^*

Example: ###-###-####

Parent/Guardian Contact Information

First Parent/Guardian Full Name^*
First Parent/Guardian Relationship To Athlete^*
First Parent/Guardian Phone Number^*

Example: ###-###-####
First Parent/Guardian Email Address^*

Example: [email protected]
Second Parent/Guardian Full Name
Second Parent/Guardian Relationship To Athlete
Second Parent/Guardian Phone Number

Example: ###-###-####
Second Parent/Guardian Email Address

Example: [email protected]
Third Parent/Guardian Full Name
Third Parent/Guardian Relationship To Athlete
Third Parent/Guardian Phone Number

Example: ###-###-####
Third Parent/Guardian Email Address

Example: [email protected]
Fourth Parent/Guardian Full Name
Fourth Parent/Guardian Relationship To Athlete
Fourth Parent/Guardian Phone Number

Example: ###-###-####
Fourth Parent/Guardian Email Address

Example: [email protected]

Family Information

Please Select the Size of Your Family Unit^*
Please Select Your Total Family Unit Income (before tax):^*
Number of Income-earning Members in the Family Unit:^*

Financial Information

KW Water Polo aims to provide assistance to athletes from families in need of financial assistance. In order for us to determine "Financial need" we require any one of the following for each income-earning member of the family unit: - Notice of Assessment - Prior year T4 - Prior year T1

You have the option of attaching a scan or a picture of the documents indicated above and upload.

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf.
Maximum # Files: 1. Maximum File Size: 4MB.

Certification

I certify that the information entered above and the documents I have uploaded or will share in hardcopy reflect all the income earning members in the family unit as indicated above.^*

Human Validation

Check The Box ^*

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Fri Jun 02, 2023

Printed from kwwaterpolo.com on Friday, June 2, 2023 at 11:59 AM